Blunting the Politics of Public Assistance

An initiative in six states seeks to stabilize the health and well-being of low-income families.

A Senior Editor of Governing, Jonathan has been covering state and local public policy and administration for more than 30 years.

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There is always tension when it comes to making various government benefit and support programs easier to access. More conservative states tend to take issue with entitlement-program spending. But thanks to a new initiative aimed squarely at helping low-income families either get back on or stay on their financial feet, the politics of public assistance is being substantially blunted.

Under the Work Support Strategies (WSS) initiative, a $25-million, multiyear program supported primarily by the Ford Foundation and administered by the Urban Institute and the Center on Budget and Policy Priorities, six states -- Colorado, Idaho, Illinois, North Carolina, Rhode Island and South Carolina -- are working to design and test efficient and effective benefits systems that "improve the health and well-being of low-income families, stabilize their family and work lives, and enable them to progress in the workforce...."

States receive $250,000 in grants and access to a wide variety of free technical assistance under the initiative. The first progress report in this multiyear effort was released last month. It highlights key findings, benefits and accomplishments. Among the findings is that high-level executive buy-in is essential in implementing reforms. In Colorado, for example, Gov. John Hickenlooper created an executive team consisting of the directors of the state's health, human services and IT agencies.

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Other key benefits of the initiative, says Jennifer Wagner, associate director of the Illinois Department of Human Services, is being able to compare notes with other states and also receive technical assistance for things like improvements in process reengineering and beefing up information technology systems.

Here are other highlights from the report:

--Illinois and Rhode Island went from "case" processing to "batch" processing, a vastly more streamlined way to handle eligibility certification and recertification, and a change that not only led to much higher client satisfaction, but also big boosts in employee morale.

--South Carolina reengineered its recertification process after data showed that tens of thousands of eligible children were routinely dropped from Medicaid, forcing the state to recertify just months later. The state also implemented a system allowing staff to use Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families records to identify and enroll Medicaid-eligible children, which officials expect will save the state at least $1 million a year in administrative costs.

--North Carolina launched a two-county pilot to align SNAP and Medicaid recertification periods, and again to smooth out recertification and prevent wasteful dropping of cases. In fact, aligning recertification periods was part of a systemwide effort to reengineer eligibility screening across all programs, which wound up obviating the need for a planned multimillion dollar call center.

--Idaho now "pre-fills" application forms with any existing information about a family from other program applications. The state is also aligning recertification periods.

--Colorado secured multimillion dollar funding from the legislature for an overhaul of its automated eligibility system.

Virtually all the states worked on improving not only their capacity to collect data but also to train staff on how to use data to manage. Key to those efforts, notes the report, were that improvements in technology went hand in glove with improvements in process. "If you just apply technology to bad processes, you just have a faster way of doing inefficient things," noted one North Carolina WSS team member in the report.

The next three years of the initiative will be spent taking local pilot projects statewide, and refining data collection and analysis. It will also involve shooting for one particularly ambitious goal, notes Chauncy Lennon of the Ford Foundation: Getting all states to "95 percent same-day eligibility determination."

But what Lennon hopes above all is that the six states will answer the question underpinning the entire project. If states actively, efficiently and consistently get a full package of benefits to people who need them, Lennon asks, "does that help them transition off of public assistance faster than other folks?"